BOOK
Cardiac Markers, An Issue of Clinics in Laboratory Medicine, E-Book
(2014)
Additional Information
Book Details
Abstract
Topics in this clinically focused publication devoted to Cardiac Markers include: Overview of cardiac markers in heart disease; Methodologies for measurement of cardiac markers; Natriuretic peptides in HF and ACS; Tropoinins and high sensitivity troponins; Point-of-care testing for cardiac markers; ST-2 and galectin 3 in patients with heart failure; Cardiac markers following heart surgery and percutaneous coronary intervention; Cholesterol, lipoproteins, high sensitivity CRP and other risk factors for atherosclerosis; Myocarditis and cardiac transplant and rejection; New molecular genetic tests in the diagnosis of heart disease; Biomarkers for cholesterol balance.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Clinics in Laboratory Medicine | i | ||
| Copyright page\r | ii | ||
| Contributors | iii | ||
| Editor | iii | ||
| Authors | iii | ||
| Contents | v | ||
| Forthcoming Issues | ix | ||
| June 2014 | ix | ||
| September 2014 | ix | ||
| December 2014 | ix | ||
| Recent Issues | ix | ||
| December 2013 | ix | ||
| September 2013 | ix | ||
| June 2013 | ix | ||
| Preface: Cardiac Markers | xi | ||
| Dedication | xii | ||
| Reference | xii | ||
| Overview of Cardiac Markers in Heart Disease | 1 | ||
| Key points | 1 | ||
| Introduction | 1 | ||
| Cardiovascular biomarkers by pathophysiological processes | 3 | ||
| Myocyte Injury | 3 | ||
| Myocyte Stress | 6 | ||
| Neurohormones | 7 | ||
| Inflammation | 7 | ||
| Vulnerable Plaque | 8 | ||
| Oxidative Stress | 8 | ||
| Extracellular Matrix Remodeling | 8 | ||
| Extracardiac Involvement | 9 | ||
| Other markers | 10 | ||
| FGF23 and Klotho | 10 | ||
| Small Molecules | 10 | ||
| MicroRNAs | 11 | ||
| Summary | 11 | ||
| References | 11 | ||
| Clinical Features of Heart Failure and Acute Coronary Syndromes | 15 | ||
| Key points | 15 | ||
| Congestive heart failure | 15 | ||
| Introduction | 15 | ||
| Clinical Presentation of CHF | 16 | ||
| Physical Examination Findings | 17 | ||
| Diagnostic Findings | 18 | ||
| Medical Therapies in CHF | 19 | ||
| Heart Failure with Preserved Ejection Fraction | 20 | ||
| Summary | 20 | ||
| Clinical features of ACS | 21 | ||
| Introduction | 21 | ||
| Clinical Presentation | 21 | ||
| Physical Examination Findings | 22 | ||
| ECG | 22 | ||
| STEMI | 22 | ||
| NSTEMI and UA | 23 | ||
| LBBB and ventricular paced rhythms | 23 | ||
| Laboratory Markers | 23 | ||
| Management | 24 | ||
| STEMI | 24 | ||
| NSTEMI/UA | 25 | ||
| Summary | 26 | ||
| References | 26 | ||
| Cardiac Markers of Myocardial Necrosis | 31 | ||
| Key points | 31 | ||
| Introduction | 31 | ||
| The ideal cardiac biomarker | 32 | ||
| Current definition of acute myocardial infarction | 33 | ||
| Chronology of cardiac biomarkers of myocyte necrosis | 33 | ||
| AST | 33 | ||
| CPK and Creatine Kinase MB | 34 | ||
| Lactate Dehydrogenase and Lactate Dehydrogenase Isoenzymes | 36 | ||
| Myoglobin | 36 | ||
| Multimarker Cardiac Panels | 36 | ||
| Point-of-care Testing for Cardiac Markers | 38 | ||
| Troponin I and T | 38 | ||
| References | 40 | ||
| Natriuretic Peptides in Heart Failure and Acute Coronary Syndrome | 43 | ||
| Key points | 43 | ||
| NP | 44 | ||
| Physiology | 44 | ||
| Analytical Properties | 45 | ||
| Heart failure | 47 | ||
| BNP and NT-proBNP | 47 | ||
| Diagnosis: acute setting | 47 | ||
| Diagnosis: outpatient setting | 49 | ||
| Factors that influence NP values | 49 | ||
| Prognosis in HF | 50 | ||
| Management | 51 | ||
| ANP | 52 | ||
| CHD including ACS | 53 | ||
| Diagnosis in ACS | 53 | ||
| Prognosis and Therapeutic Intervention in ACS | 53 | ||
| Future directions | 54 | ||
| References | 54 | ||
| Cardiac Troponins and High-sensitivity Cardiac Troponin Assays | 59 | ||
| Key points | 59 | ||
| Introduction | 59 | ||
| Structure and function of cardiac troponins | 60 | ||
| Components of the Cardiac Troponin Complex | 60 | ||
| Cardiac Troponin Genes | 60 | ||
| Cardiac Troponin Gene Expression | 60 | ||
| Translation and Posttranslational Modifications | 60 | ||
| Troponin Release from Cardiac Myocytes | 60 | ||
| Cardiac troponin assays | 61 | ||
| History of Cardiac Troponin Immunoassays | 61 | ||
| Standardization of Cardiac Troponin Immunoassays | 61 | ||
| What Defines a High-sensitivity Cardiac Troponin Assay? | 62 | ||
| Investigational High-sensitivity Assays | 63 | ||
| Cardiac troponin as a diagnostic tool | 65 | ||
| Definition of Myocardial Infarction | 65 | ||
| Preferably Cardiac Troponin | 66 | ||
| 99th Percentile URL | 66 | ||
| Increase and/or Decrease | 67 | ||
| Acute Conditions with Increased Cardiac Troponin Other than MI | 67 | ||
| Cardiac troponin as a prognostic tool | 68 | ||
| Short-term Prognosis | 69 | ||
| Long-term Prognosis | 69 | ||
| Chronic Conditions with cTn Increases | 70 | ||
| Summary | 70 | ||
| References | 70 | ||
| The Benefits of a Rapid, Point-of-Care “TnI-Only” Zero and 2-Hour Protocol for the Evaluation of Chest Pain Patients in the ... | 75 | ||
| Key points | 76 | ||
| Introduction | 76 | ||
| Methods | 77 | ||
| Results | 78 | ||
| Discussion | 80 | ||
| Summary | 83 | ||
| References | 84 | ||
| Soluble ST2 and Galectin-3 in Heart Failure | 87 | ||
| Key points | 87 | ||
| Introduction | 87 | ||
| ST2 | 88 | ||
| The Discovery of ST2: From Bench to Bedside | 88 | ||
| sST2: Analytical Considerations | 88 | ||
| ST2: Prognosis and Use in Acute HF Syndromes | 88 | ||
| ST2: Association with Cardiac Structure and Function in HF | 89 | ||
| sST2 and Chronic HF | 90 | ||
| sST2: Future Applications | 90 | ||
| ST2: Summary | 91 | ||
| Galectin-3 | 91 | ||
| The Discovery of Galectin-3 in HF: A Marker of Extracellular Matrix Remodeling | 91 | ||
| Galectin-3: Analytical Considerations | 91 | ||
| Galectin-3 in Acute HF: Prognosis and Cardiac Structure | 92 | ||
| Galectin-3 and Chronic HF | 92 | ||
| Special Topic: Galectin-3 and HF with Preserved Ejection Fraction | 93 | ||
| Galectin-3 and Advanced HF | 93 | ||
| Galectin-3: Summary | 94 | ||
| References | 94 | ||
| Cardiac Markers Following Cardiac Surgery and Percutaneous Coronary Intervention | 99 | ||
| Key points | 99 | ||
| Introduction | 99 | ||
| Type 4 and 5 MI | 100 | ||
| 2000 Universal Definition of MI | 100 | ||
| 2007 Universal Definition of MI | 102 | ||
| 2012 Universal Definition of MI | 102 | ||
| Myocardial injury after PCI | 102 | ||
| Stent Thrombosis (Type 4b MI) | 104 | ||
| Neointimal Hyperplasia | 104 | ||
| Neo-atherosclerosis | 105 | ||
| Myocardial injury after cardiac surgery | 106 | ||
| Cardiac Markers and CABG | 106 | ||
| Graft Thrombosis | 107 | ||
| Cardiac Markers and Nonrevascularization Cardiac Surgery | 108 | ||
| Summary and recommendation | 108 | ||
| References | 108 | ||
| Cholesterol, Lipoproteins, High-sensitivity C-reactive Protein, and Other Risk Factors for Atherosclerosis | 113 | ||
| Key points | 113 | ||
| Introduction | 113 | ||
| Pathogenesis of atherosclerosis | 114 | ||
| The role of lipoproteins | 115 | ||
| Treatment goals | 115 | ||
| Lipoprotein analysis | 116 | ||
| Novel biomarkers | 118 | ||
| High-sensitivity C-reactive protein | 118 | ||
| Apolipoprotein-associated phospholipase A2 | 120 | ||
| Myeloperoxidase and oxidized LDL | 121 | ||
| Lipoprotein (a) | 122 | ||
| Genetics | 123 | ||
| Apolipoprotein E polymorphisms | 123 | ||
| Apolipoprotein (a) polymorphisms | 124 | ||
| Proprotein convertase subtilisin/kinexin type 9 | 124 | ||
| Summary | 124 | ||
| References | 125 | ||
| Special Topics: Cardiac Markers in Myocarditis | 129 | ||
| Key points | 129 | ||
| Introduction | 129 | ||
| Myocarditis | 130 | ||
| Cardiac transplant rejection | 131 | ||
| Elevations in cardiac troponin in patients without acute coronary syndrome or heart failure | 132 | ||
| References | 135 | ||
| New Molecular Genetic Tests in the Diagnosis of Heart Disease | 137 | ||
| Key points | 137 | ||
| Cardiomyopathy | 137 | ||
| Hypertrophic Cardiomyopathy | 138 | ||
| Phenotype | 138 | ||
| Prevalence and genetic causes | 138 | ||
| Cellular mechanism | 138 | ||
| Overlap with other syndromes | 140 | ||
| Dilated Cardiomyopathy | 140 | ||
| Phenotype | 140 | ||
| Prevalence and genetic causes | 140 | ||
| Biomarkers for Cholesterol Absorption and Synthesis in Hyperlipidemic Patients | 157 | ||
| Key points | 157 | ||
| Introduction | 157 | ||
| Biomarkers of cholesterol synthesis and absorption | 158 | ||
| Cholesterol Synthesis Pathway | 158 | ||
| Mechanism of Cholesterol Absorption | 158 | ||
| Analytical Analysis of Cholesterol Synthesis and Absorption Biomarkers | 159 | ||
| Cholesterol absorption and synthesis markers as risk factors for coronary heart disease | 161 | ||
| Effect of lipid-lowering drugs on cholesterol synthesis and absorption | 162 | ||
| Proposed clinical use of cholesterol absorption and synthesis tests | 164 | ||
| References | 165 | ||
| Methodologies for Measurement of Cardiac Markers | 167 | ||
| Key points | 167 | ||
| Introduction | 167 | ||
| Cardiac biomarkers | 168 | ||
| Assay formats and designs | 168 | ||
| Principles of Immunometric Assay Design | 168 | ||
| Point-of-Care Assay Design | 173 | ||
| Multiplex Assay Design | 174 | ||
| Limitations of antibody-based assays for cardiac biomarkers | 176 | ||
| Technical Limitations | 176 | ||
| Assay insensitivity | 176 | ||
| Lack of specificity | 177 | ||
| Specimen-specific interferences | 178 | ||
| Interpretive Limitations | 179 | ||
| Summary | 182 | ||
| Appendix: Definitions and terms | 182 | ||
| Accuracy (Analytical) | 182 | ||
| Analyte | 182 | ||
| Calibrator | 182 | ||
| Immunoassay | 182 | ||
| Immunometric Assay | 183 | ||
| Limit of Detection (LOD) | 183 | ||
| Limit of Quantitation | 183 | ||
| Precision (Analytical) | 183 | ||
| Sensitivity (Analytical) | 183 | ||
| Specificity (Analytical) | 184 | ||
| References | 184 | ||
| Index | 187 | ||
| A | 187 | ||
| B | 188 | ||
| C | 188 | ||
| D | 190 | ||
| E | 190 | ||
| F | 190 | ||
| G | 190 | ||
| H | 191 | ||
| I | 191 | ||
| J | 192 | ||
| K | 192 | ||
| L | 192 | ||
| M | 192 | ||
| N | 193 | ||
| O | 193 | ||
| P | 194 | ||
| Q | 194 | ||
| R | 194 | ||
| S | 194 | ||
| T | 195 | ||
| V | 196 |